摘要
目的 探讨显微手术切除大型听神经瘤 (L AN)的治疗效果 .方法 CT或 MRI证实位于桥脑小脑角区的直径≥31mm L AN2 16例 ,采用显微手术切除 ,术后评估治疗效果 ,分别比较术前、术后的听神经和面神经功能 .结果 肿瘤全切率 79.6 % (172例 ) ;次全切除率 15 .3% (33例 ) ;部分切除率 5 .1% (11例 ) ;术后死亡率 1.4% (3例 ) .听神经解剖学保留率为 12 .5 % (2 7例 ) ,出院时神经功能保留率为 4.2 % (A级 ,9例 ) ;面神经解剖学保留率为 82 .4% (178例 ) ,出院时神经功能保留率为 5 2 .8% (House分级 , ～ 级 94例 ) .对187例平均随访 3.9a,其中 12 8例 (6 8.4% )恢复良好 ,44例(2 3.5 % )恢复较好 ,15例 (8.0 % )恢复较差 ,后者中有 10例(5 .4% )肿瘤复发 (再次治疗后治愈 ) .结论 显微外科手术切除大型听神经瘤安全。
AIM To probe the therapeutic effects of large acoustic neuroma (LAN) using the microsurgical technique. METHODS A total of 216 patients with LAN in cerebellapontine angle were confirmed by CT or MRI in our department. Each tumor (the diameter≥31 mm) was removed with the microsurgery. The therapeutic results were evaluated and the preoperative and postoperative function of acoustic nerve or facial nerve were compared respectively. RESULTS The tumors were total removal in 172 cases ( 79.6% ), subtotal removal in 33 cases (15.3%) and partial removal in 11 cases (5.1%). The anatomic preservation of acoustic nerve was achieved in 27 cases (12.5%), and the functional preservation in 9 cases (grade A, 4.2%) at discharge. The anatomic preservation of facial nerve was achieved in 178 (82.4%), and the functional preservation in 94 cases (House grade, grade Ⅰ～Ⅱ 52.8%) at discharge. Follow up observation (Median: 3.9 years) of 187 cases revealed good recovery in 128 patients (68.4%), fair recovery in 44 cases (23.5%) and poor recovery in 10 cases (8.0%). The late recurrence in poor recovery was 10 cases (5.4%) (cured by the second treatment). CONCLUSION It is a safe and effective way to remove LAN with the microsurgical technique.
出处
《第四军医大学学报》
2000年第10期1288-1291,共4页
Journal of the Fourth Military Medical University
基金
国家自然科学基金资助项目!(39970 85 4)
